2010-11-01

FY 2011 Funding for NIH Still in Question

Because of a shortened congressional schedule due to the mid-term elections, Congress was not able to complete work on any of the fiscal year (FY) 2011 spending bills to fund the federal government and various federal programs, including the National Institutes of Health (NIH). The federal FY began on October 1 with the appropriations process not finalized, so Congress passed a continuing resolution to avoid a government shut-down and fund the federal government and programs at FY 2010 levels through December 3, 2010. Following the November elections, Congress will convene a “lame duck” session to complete work on the FY 2011 funding bills.

Draft proposals in both the House and Senate recommend just over $32 billion for NIH — an amount equal to the President’s FY 2011 request for NIH and approximately $1 billion (3.2 percent) over the final FY 2010 funding levels that were enacted in December of last year. This falls short of the $35 billion in funding that ASH and the biomedical research community have advocated for NIH in FY 2011.

ASH will continue its advocacy efforts supporting increases for NIH on Capitol Hill throughout the remainder of the FY 2011 budget debate. The Society encourages all members to visit the ASH Advocacy Center at www.hematology.org/takeaction to join ASH’s campaign urging Congress to support increased funding for NIH.

Congress Seeks to Prevent Medicare Physician Payment Cuts in “Lame Duck” Session

As this issue of The Hematologist was going to press, the November 30 deadline for addressing a 23 percent Medicare physician payment cut was fast approaching, but Congress had not yet taken action and planned to tackle the issue during a “lame-duck” session following the mid-term elections.

Throughout 2010, Congress has enacted a series of short-term, stop-gap measures to avert scheduled Medicare physician payment cuts. In June, Congress passed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (P.L. 111-192). The law canceled the scheduled 21 percent pay cut for doctors and replaced it with a 2.2 percent increase but only averted physician payment cuts through the end of November. Although it is unclear precisely how congressional leaders will proceed, legislation will have to be passed to avert the scheduled cut from going into effect at that time.

ASH strongly believes the solution to this physician payment problem is to permanently replace the current payment formula with a system that keeps pace with the cost of caring for our nation’s seniors and does not threaten the viability of physician practices. Continuing the practice of enacting temporary patches serves no one well. The cost of a permanent solution is expensive and the details are complicated and will take time to work out. Consequently, the Society is advocating for Congress to pass a statutory payment update when it returns in November, before cuts take effect again, that lasts at least through the end of 2011. For the latest information about legislative action on Medicare physician payments, visit the ASH website at www.hematology.org.

NIH Resumes Funding Stem Cell Research as Judicial and Legislative Action Continues

On August 23, a federal court prohibited federal funding of human embryonic stem cell (hESC) research pending the outcome of a lawsuit challenging the Obama administration’s new policies on stem cell research. Since this decision, there has been tremendous activity, both legislatively and in the courts. On September 28, a federal appeals court issued a stay on the injunction, allowing the National Institutes of Health (NIH) to continue funding hESC research as the original case works its way through the court process.

Meanwhile, ASH continues to urge Congress to act by passing legislation to permanently allow hESC research to continue. ASH has supported the Stem Cell Research Advancement Act (H.R. 4808 in the House and S. 3766 in the Senate). Although the two bills are not exactly the same, they both would codify President Obama’s Executive Order ensuring NIH support for hESC research. All ASH members are encouraged to visit the ASH Advocacy Center at www.hematology.org/takeaction to join ASH’s campaign and send a letter to their Representative and Senators urging passage of legislation ensuring the continued availability of federal funding for hESC research. It is critical that the Congress hear from constituents about the need for this legislation so that it will take action when it returns to Washington after the November elections.

Initial Health-Care Reforms Take Effect as Partisan Debate Continues

The first provisions of the Patient Protection and Affordable Health Care Act (PPACA) went into effect in September. Although most of the law will not become effective until 2014, the Obama Administration insisted that the first round of implementation include consumer protections to address complaints with the insurance industry, many of which will impact patients with hematologic disease. These provisions are:

• End-of-Lifetime Limits – plans will no longer be able to place lifetime caps on the dollar amount of benefits. If an individual’s policy had a lifetime cap, he or she will receive notification that the cap has been lifted.
• Annual Limit Minimums – the gradual phase-out of the annual limit dollar amount for all group policies and new individual policies begins. For a plan or policy year beginning between September 23, 2010, and September 22, 2011, the minimum annual limit can be no less than $750,000. The minimum annual limit amount will increase in subsequent years until it is eliminated in 2014.
• End of Pre-Existing Condition Exclusions for Children – new individual or existing group plans will have to accept children under the age of 19, regardless of a pre-existing condition. This will extend to all plans and all ages in 2014.
• End of Rescissions and Cancellations – plans can no longer drop a patient’s coverage, except in cases of fraud.
• Dependent Coverage Extended – young adults will be able to stay on their parents’ health plan until age 26.

Opponents of the legislation have stepped up their attacks. Congressional Republican leaders have charged that the new law has too much government involvement and does not reduce health-care costs, and they have called for repeal of the legislation or specific components. Meanwhile, an increasing number of consumer and patient advocacy groups have joined the Administration in promoting the new provisions and argue that any attempt to repeal health reform will become increasingly unpopular, because repeal from this point forward would mean taking away new benefits from people.

ASH continues to monitor implementation of health reform. A special discussion on the impact of health reform on hematology will be featured at the Grassroots Network Breakfast during the annual meeting in December.

NIDDK Celebrates Its 60th Anniversary With a Special Symposium

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is currently celebrating its 60th anniversary through events that highlight research advances in hematologic diseases and other research areas that have been supported by NIDDK. As part of the celebration, ASH will be holding a special symposium celebrating NIDDK’s 60th anniversary as part of the 2010 ASH Annual Meeting.

The special symposium, which is scheduled for Monday, December 6, from 4:30 to 6:00 p.m., will be chaired by NIDDK Director and ASH Member Dr. Griffin Rodgers and will feature presentations by Drs. Kenneth Kaushansky, Alan Schechter, and Nancy Andrews highlighting advances and future opportunities for progress in three key areas of hematology research supported by NIDDK during its 60-year history — hematopoiesis, hemoglobin, and iron.